Insurance Exchange at a Crossroads

Coverage for 1.4 million at stake as consumer, industry groups disagree

Last fall, the Illinois legislature failed to pass a bill after consumer and industry groups split on two key issues. The disagreements centered on whether the insurance industry should have a seat on the exchange's governing board, and whether the exchange would be an active purchaser of insurance or simply a market organizer.

Consumer groups, including AARP Illinois and Illinois PIRG, oppose giving the insurance industry a seat on the board. Creasey said no one from the industry should be on the governing board because it would be a conflict of interest.

State Rep. JoAnn D. Osmond, R-Antioch, who holds an insurance license but doesn't practice, said the board needs the experience an industry representative would bring.

A possible compromise would allow someone who's retired from the insurance industry to serve.

AARP and Illinois PIRG want the exchange to require insurers to provide high-quality plans and lower prices for consumers. The insurance industry argues that would drive up the cost of policies and make fewer alternatives available.

"The concern always is the heavy-handed approach from the government side," said Laura Minzer, executive director of the Illinois Chamber of Commerce's Healthcare Council, which wants the exchange to supplement, but not control, the health insurance market.

Illinois lawmakers also worry about what would happen if federal grants promised by the Affordable Care Act are cut, or if the Supreme Court strikes down the law. The state has until June to apply for additional federal grant money to fund the exchange, but it would have to be self-sustaining by 2015.

"If the money for that, which is supposed to come from the feds, goes away, then I can tell you from the structure of our budget: we don't have $90 million to set this up," said state Rep. Frank Mautino, D-Spring Valley.

Osmond said she is concerned because when Massachusetts established a similar exchange, "they kept going back to the legislature for more money and more direction."